{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:44:40Z","timestamp":1790912680796,"version":"4.1.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin J Gastroenterol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Hepatic hemangiomas are typically asymptomatic benign liver tumors. This report describes a case of a large hepatic hemangioma with internal bleeding and necrosis, presenting as fever of unknown origin, which was successfully treated with surgical resection. A woman in her 40s presented with persistent fever and fatigue. Imaging revealed a 13 cm mass in the posterior sector of the right hepatic lobe, with areas of high attenuation suggestive of internal bleeding. Laboratory tests revealed elevated levels of C-reactive protein, interleukin-6, and complement components (C3, C4, and CH50), along with an increased erythrocyte sedimentation rate. Symptomatic treatment with antipyretic medications failed to resolve the fever; therefore, hepatic resection was performed for diagnostic and therapeutic purposes. Post-operative recovery was uneventful, and the fever resolved completely. Pathological examination revealed cavernous hemangioma with well-defined necrotic areas. Post-operative blood tests showed normalization of the preoperatively elevated prognostic markers. Bleeding and necrosis associated with a large hemangioma appear to trigger the release of damage-associated molecular patterns, stimulating interleukin 6 production, promoting prostaglandin E2 synthesis, and ultimately leading to fever. Hepatic resection is an effective treatment for large hemangiomas in patients presenting with fever.<\/jats:p>","DOI":"10.1007\/s12328-025-02145-8","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T14:10:47Z","timestamp":1747923047000},"page":"706-713","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Giant hepatic hemangioma with internal necrosis discovered due to fever of unknown origin and treated successfully with surgical resection: a case report"],"prefix":"10.1007","volume":"18","author":[{"given":"Rei","family":"Ryozawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2082-3202","authenticated-orcid":false,"given":"Hirohito","family":"Takeuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsutoshi","family":"Sugimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Osakabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chie","family":"Takishita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Matsubayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Nagakawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshitaka","family":"Nagao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Itoi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"2145_CR1","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1159\/000536487","volume":"18","author":"K Kimura","year":"2024","unstructured":"Kimura K, Ichita C, Sumida C, et al. 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